Integrative Oncology in the UK: current perspectives and future directions
There are around 30 million cancer survivors globally, who often live with complex and unmet physical and psychosocial needs, secondary to both cancer and cancer treatment they have received. Typical long-term complications of cancer and its treatment, which can have adversely affect people’s quality of life, working and personal relationships, include fatigue, cognitive dysfunction, depression, infertility, lymphoedema, chronic pain, early menopause and osteoporosis. In addition, remote patient surveillance schemes such as ‘patient-initiated follow up’ and digitally-led outcome measure collection, means that patients have less contact with their oncology teams during the survivorship phase. Moreover, patients living with advanced cancer and undergoing treatment for metastatic cancer do not have standard access to integrative oncology services, meaning access to nutrition and lifestyle support and complementary therapies outside mainstream treatments. Coordination of person-centred and individualised care to include aspects of integrative oncology, as well as funding to support this, are current unresolved issues in the UK.
Many people with cancer see their cancer diagnosis as an opportunity for lifestyle changes and health promotion (adoption of an exercise routine, diet modification, smoking cessation etc). As a result, between 40% and 90% of cancer patients seek complementary and alternative therapies outside their clinical team and without discussing with them. The co-location of integrative medicine facilities under the same roof with standard oncological treatment is rare in the UK NHS with some distinct examples in the private healthcare sector only. Consequently, people with cancer often seek many disparate sources of information that can differ in quality and coverage of the patients’ needs. Integrative cancer care services are currently mainly privately led, which means that only those who can afford to pay can have access to them.
The future of integrative oncology in the UK should go hand in hand with the other government-led cancer priorities, including early diagnosis, advanced and timely treatment modality provision, cancer prevention and lifestyle change. Supportive UK cancer associations will drive the integrative oncology agenda forward in the UK and in collaboration with international partners. A combination of published clinical practice guidelines, research, training and digital innovations, will support integrative oncology adoption and will enable the formation of new policy and support delivery of this much needed approach in healthcare.